Background: Arterial stiffness has been recognized as a significant predictor of cardiovascular risk, while experimental data indicate that angiotensin II receptor blocker (ARB) treatment reduces arterial stiffness. The purpose of the present study was to assess ARB treatment on arterial stiffness in hypertensive patients.

Methods: We studied 81 consecutive, untreated, nondiabetic patients (mean age 52 years, 47 males) with uncomplicated essential hypertension who were administrated to 6-month monotherapy with either irbesartan (n = 47) or candesartan (n = 34). Large-artery stiffness and arterial wave reflections indices [carotid-femoral pulse wave velocity (PWVc-f), carotid-radial pulse wave velocity (PWVc-r) and augmentation index (AIx)] were measured before and after ARB antihypertensive treatment.

Results: ARB antihypertensive treatment reduced all elastic properties indices (AIx: from 26.3 to 21.2%, PWVc-f: from 7.7 to 7.3 m/s and PWVc-r: from 8.9 to 8.3 m/s, p < 0.001). After adjusting for systolic blood pressure, PWVc-f change remained significant (p < 0.001), but that was not seen for PWVc-r and AIx change (p = NS). No differences between the two agents were detected (p = NS).

Conclusion: Chronic ARB treatment may affect favorably arterial stiffness and wave reflections in hypertensive patients, while lowering of PWVc-f may account for the therapeutic benefit conferred by irbesartan and candesartan independently of their blood pressure lowering effect.